You sent them off to college in the fall, full of pride, excitement… and probably some worry. Your worries might have been about academics, healthy relationships, finances and maybe even drugs and alcohol. The list of things we worry about as parents can feel endless.
While college can be an incredibly positive experience for many young adults, it is undoubtedly stressful and exhausting to undergo such a major life transition. The stressors of the college environment make it ripe for the development of many health and mental health problems, and eating disorders are no exception.
Now that the academic school year has come to a close, many college students have flown back to the nest for a summer reprieve. Whether your student was a freshman, a senior, or anywhere in between, this is an important time for parents to check-in about how their child has grown and matured, how they’ve been coping with the stress of school and to support any ongoing needs they may have before the next semester or stage of life begins.
Being back under the same roof again, eating meals together, means this also tends to be a time when many parents notice the signs of their college student’s struggle with an eating disorder. Some of the red flags that parents first report include:
- Changes in eating and/or exercise habits: They may strictly adhere to new rules about what they can and cannot eat. They might also exercise excessively, even if it gets in the way of other important obligations or even when it’s dangerous to do so (ex: running despite a knee injury or driving to the gym in hazardous weather conditions).
- Increased concerns about shape/weight: Frequent comments about their own body size (ex: “I’m too fat”) and that of others (ex: “She’s in such good shape!”) might suggest your child has a heightened focus on shape/weight. This may also be indicated by behaviors such as frequently weighing themselves or choosing to wear loose clothing to hide changes in their body shape.
- Preoccupations with food and eating: Frequent dieting is one of the strongest predictors of the development of an eating disorder. Other key indicators include practices related to dieting such as tracking intake with an app, counting calories, cutting out entire food groups (e.g., veganism, the keto diet) and other restrictive practices that often result in increased anxiety or obsessionality about food; some people may frequently cook/bake food for other people that they themselves refuse to eat.
- Secrecy and isolation: Eating disorders thrive in secrecy. You may notice your child choosing to eat dinner alone in their room instead of with the family or making other plans or excuses to avoid family mealtimes altogether. You may also find food, detox or diet product packaging hidden in the house. In line with this, they may withdraw from old friends and no longer engage in activities they used to enjoy.
- Concentration difficulties: People affected by eating disorders are typically not receiving adequate levels of nutrition to function at their best. This nutritional deficit not only affects the body but also the brain, making it incredibly difficult to stay focused for even a short period of time (ex: frequently “zoning out” during conversation, slowed reaction time, poor recall).
- Mood and energy changes: The way we eat and the amount of nutrients we consume impacts the brain’s ability to process and respond appropriately to emotionally triggering events—this means that even minor disturbances, like spilling coffee on a new shirt, can be incredibly distressing for someone who’s not getting consistent or adequate nutrition. Your child might seem “down” or lack energy, or they may seem “on edge” or especially anxious—either could be evidence of a co-occurring mental health concern or a result of an eating disorder.
What to Say & How to Say It
When you’ve been looking forward to your’ child’s return from school all year, it can be jarring to notice any of these red flags. It’s tough to tackle eating and mental health issues with children at any age, but it’s further complicated with college-age children as they emerge into adulthood and a new type of independence. So, how do parents approach such personal topics with young adult children, while still respecting them as an autonomous individual? It’s always best to consult a professional regarding your family’s specific situation but here are a few general recommendations:
- Respect your child’s privacy: Breaching the subject at a family gathering or public place is not the best idea. Your child is much more likely to be open and responsive if you voice your concern in a private, one-on-one setting, as this allows them a safe space to discuss such a personal issue.
- Practice open, nonjudgmental communication: Eating disorders are highly stigmatized, and many who suffer may be reluctant to disclose their struggles with food and body image. Some may vehemently deny their problematic behaviors, while others may lack awareness that there even is a problem. The best way to combat stigma is through open discussion about eating disorders. Ask your child how they feel about their eating habits or body image, listen openly to their response, and withhold any judgmental or invalidating remarks. Make them feel heard by using their own words to reflect their statements and expressing validation of their pain (ex: “I am so sorry that you have been feeling […], it sounds like dealing with […] has been really tough.”).
- Avoid blame: Steer clear of accusatory “you” statements (ex: “You need to eat more!”) that place unnecessary blame on your child and may trigger a defensive reaction from them. Instead, opt for “I” statements that allow your child to hear your concerns without feeling the need to defend themselves (ex: “I am concerned about the safety of this new diet product,” or, “I noticed you’ve had very little energy lately which is unusual for you.”)
- Come prepared: When discussing triggering topics, it’s easy to let our emotions get the better of us and turn the conversation into a hostile argument. It may be helpful to think of what you want to say beforehand. Still, don’t be surprised if you’re met with some resistance or denial. Educate yourself about eating disorders– the risk factors, the physical and emotional consequences, and treatment options.
Once you’ve communicated your concern, what can you do to ensure your child gets the proper care they need? Refer to our brief online assessment, which can be completed by your child themselves, or by you based on your observations of their behavior. This brief assessment provides valuable information about potentially problematic eating behaviors along with resources and suggestions for how to proceed.
We also offer FREE weekly support groups for individuals at any stage in eating disorder recovery, as well as their parents, friends, and loved ones. These groups are open to anyone – meaning your child does not need to be a patient at CED to attend, and parents are welcome to attend with or without their child.
If you are still concerned, the best option is to speak to a licensed professional who can provide a formal diagnosis and recommend treatment options depending on your child’s unique needs. Here at The Center for Eating Disorders, we have licensed mental health professionals available to consult with you over the phone and diverse programming throughout all levels of care. If you’re concerned about your child, please call us at (410)-938-5252 to to discuss next steps.
For more on how the stress of the college environment can play a role in the development of eating disorders, see Eating Disorders & The Transition to College.
Jacquelyn Patton, Research Assistant
Jacquelyn is a graduate student currently pursuing her Masters in Clinical Psychology at Towson University, with the intent to earn her degree in May 2020. She received her Bachelors of Science in Psychology from the University of Maryland, College Park in 2017. As an undergraduate, Jacquelyn served as a research assistant for the Center for Addiction, Personality, and Emotions Research where she conducted a study examining the impact of racism and racial/ethnic identity formation on health-risk behaviors, including disparate patterns of substance use. She joined the research team at CED as a volunteer research assistant in 2018 and worked on researching the utility and efficacy of telemedicine in the treatment of eating disorders.
Anorexia and Bulimia Care. (n.d.). Parents. Retrieved from http://www.anorexiabulimiacare.org.uk/family-and-friends/parents
National Eating Disorder Association. (2018, February 22). Warning Signs and Symptoms. Retrieved from http://www.nationaleatingdisorders.org/warning-signs-and-symptoms
National Eating Disorder Association. (2015). NEDA TOOLKIT for Parents. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf